MA-PD HMO to Med Supp & PDP

[DS4]

I got a lead today and I need add'l opinions. Most of what I do in senior business is T65, or, from one med supp to another med supp.
The woman that called just moved her mom/dad to our town from a larger town were both parents are enrolled in a MA-PD HMO. Her parents are now out of the HMO's area of service.
She has POA for her parents as one has Alzheimer's and the other has advanced dementia. They both take a boat load of Rx's. Both will hit the coverage gap. Not a big prob as they both have many $$$$.
The daughter faxed me a list of their meds. I ran their meds through the Medicare Formulary Finder.
The daughter and I decided on AARP Plan F/PDP for both.
Because the parents are now outside the HMO's service area, this would trigger guaranteed acceptance into Plan F, and, a PDP.
As the daughter just moved both parents, the HMO knows nothing.
The daughter wants both parents on Med Supps and PDP's 4.01.10.
Here is my question. What docs do I provide AARP to demonstrate both parents now live outside the service area, therefore triggering guaranteed acceptance into Plan F?
Do I just submit apps with the new address with a copy of their HMO Id card?
I would need to get approval of the med supp, then, submit the PDP. The submission of the PDP would trigger the Cx of the MA-PD HMO.
Am I thinking correctly?

 

[Josh]

I'm not sure what AARP is going to want, but this is the reference guide BCBS put out: https://www.blueshieldca.com/producer/documentlibrary/MSP17149.pdf.

It's all well and good that the daughter wants them on sups and pdp's by 4.10.10, but they might need to wait to get the notification of termination of coverage from the MA-PD. If they notify the plan of the move (or perhaps Medicare) then they will get a letter from the MA carrier that the coverage is being terminated because of the move and then you'd have the paper trail for it. The best thing you could do is call up AARP and ask them what they'd want to see, but that's probably pretty close.

 

[DS4]

Here in Ca, AARP only asks the end stage question. Both applicants can answer no to that question.
So....why wouldn't I just use the OEP to put both back onto Medicare primary 4.01.10, enroll in a PDP and submit AARP apps ?
Keep the whole "moved out of area" quiet.

 

[Josh]

Here in Ca, AARP only asks the end stage question. Both applicants can answer no to that question.
So....why wouldn't I just use the OEP to put both back onto Medicare primary 4.01.10, enroll in a PDP and submit AARP apps ?
Keep the whole "moved out of area" quiet.

Gotta love state regulated vs federal. If they don't need it to be a GI period then just enrolling them in the pdp to knock them out of the ma-pd makes perfect sense. Supps are always easy in New York, it's all GI all day every day for everyone!

 

[G.Gordon]

I'll second the "keep the move" issue out of it. That's really a non-issue since we're still in the OEP and they can (or the POA) decide to exit at will.

On the other hand. If AARP isn't the cheapest plan available and money was an issue (sounds like it's a non-issue here) then the loss-of-coverage letter from making the move would trigger acceptance to any company offering supplements.

 

[captain94]

In Ohio you could give them AARP to but the premium would be much, much higher than if you GI them because of the move. Maybe its not that way in your state?